Abstract
Background
There has been recent interest in using robots for general surgical procedures. This shift in technique raises the issue of patient safety with automated instrumentation. Although the safety of robotics has been established for urologic procedures, there are scant data on its use in general surgical procedures. The aim of this study is to analyze the incidence of robotic malfunction and its consequences for general surgical procedures.
Methods
All robotic general surgical procedures performed at a tertiary center between 2008 and 2011 were reviewed from institutional review board (IRB)-approved prospective databases.
Results
A total of 223 cases were done robotically, including 102 endocrine, 83 hepatopancreaticobiliary, 17 upper gastrointestinal, and 21 lower gastrointestinal colorectal procedures. There were 10 cases of robotic malfunction (4.5 %). These failures were related to robotic instruments (n = 4), optical system (n = 3), robotic arms (n = 2), and robotic console (n = 1). None of these failures led to adverse patient consequences or conversion to open. Six (2.7 %) cases were converted to open due to bleeding (n = 3), difficult dissection plane (n = 1), invasion of tumor to surrounding structures (n = 1), and intolerance of pneumoperitoneum due to CO2 retention (n = 1). There was no mortality, and morbidity was 1 % (n = 2).
Conclusion
To our knowledge, this is the largest North American report to date on robotic general surgical procedures. Our results show that robotic malfunction occurs in a minority of cases, with no adverse consequences. We believe that awareness of these failures and knowing how to troubleshoot are important to maintain the efficiency of these procedures.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Zorn KC, Gofrit ON, Orvieto MA, Mikhail AA, Galocy RM, Shalhav AL, Zagaja GP (2007) Da Vinci robot error and failure rates: single institution experience on a single three-arm robot unit of more than 700 consecutive robot-assisted laparoscopic radical prostatectomies. J Endourol 21:1341–1344. doi:10.1089/end.2006.0455
Lavery HJ, Thaly R, Albala D, Ahlering T, Shalhav A, Lee D, Fagin R, Wiklund P, Dasgupta P, Costello AJ, Tewari A, Coughlin G, Patel VR (2008) Robotic equipment malfunction during robotic prostatectomy: a multi-institutional study. J Endourol 22:2165–2168. doi:10.1089/end.2007.0407
Coelho RF, Palmer KJ, Rocco B, Moniz RR, Chauhan S, Orvieto MA, Coughlin G, Patel VR (2010) Early complication rates in a single-surgeon series of 2500 robotic-assisted radical prostatectomies: report applying a standardized grading system. Eur Urol 57:945–952. doi:10.1016/j.eururo.2010.02.001
Finan MA, Rocconi RP (2010) Overcoming technical challenges with robotic surgery in gynecologic oncology. Surg Endosc 24:1256–1260. doi:10.1007/s00464-009-0756-0
Alqahtani A, Albassam A, Zamakhshary M, Shoukri M, Altokhais T, Aljazairi A, Alzahim A, Mallik M, Alshehri A (2010) Robot-assisted pediatric surgery: how far can we go? World J Surg 34:975–978. doi:10.1007/s00268-010-0431-6
Kim WT, Ham WS, Jeong W, Song HJ, Rha KH, Choi YD (2009) Failure and malfunction of da Vinci Surgical systems during various robotic surgeries: experience from six departments at a single institute. Urology 74:1234–1237. doi:10.1016/j.urology.2009.05.071
Talamini M, Campbell K, Stanfield C (2002) Robotic gastrointestinal surgery: early experience and system description. J Laparoendosc Adv Surg Tech A 12:225–232. doi:10.1089/109264202760267970
Borden LS Jr, Kozlowski PM, Porter CR, Corman JM (2007) Mechanical failure rate of da Vinci robotic system. Can J Urol 14:3499–3501
Eichel L, Ahlering TE, Clayman RV (2004) Role of robotics in laparoscopic urologic surgery. Urol Clin North Am 31:781–792. doi:10.1016/j.ucl.2004.06.014
Kaushik D, High R, Clark CJ, LaGrange CA (2010) Malfunction of the Da Vinci robotic system during robot-assisted laparoscopic prostatectomy: an international survey. J Endourol 24:571–575. doi:10.1089/end.2009.0489
Andonian S, Okeke Z, Okeke DA, Rastinehad A, Vanderbrink BA, Richstone L, Lee BR (2008) Device failures associated with patient injuries during robot-assisted laparoscopic surgeries: a comprehensive review of FDA MAUDE database. Can J Urol 15:3912–3916
Acknowledgement
Disclosures
Authors Orhan Agcaoglu, Shamil Aliyev, Halit Eren Taskin, Sricharan Chalikonda, Matthew Walsh, Meagan M. Costedio, Matthew Kroh, Tomasz Rogula, Bipan Chand, Emre Gorgun, Allan Siperstein, and Eren Berber have no conflicts of interest or financial ties to disclose.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Agcaoglu, O., Aliyev, S., Taskin, H.E. et al. Malfunction and failure of robotic systems during general surgical procedures. Surg Endosc 26, 3580–3583 (2012). https://doi.org/10.1007/s00464-012-2370-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-012-2370-9